Alison Trewhela in Supta Padangusthasana yoga pose Ustrasana yoga painting by Perran Trewhela Alison Trewhela in Chair Savasana


Yoga Research 


The 'Yoga for Healthy Lower Backs' yoga programme was shown to be a safe and effective treatment option for those with a history of chronic and recurring low back pain that could be recommended by physicians and clinicians. The Annals of Internal Medicine journal published our research results paper (Nov 1st 2011).

Spine journal published our research results cost-effectiveness paper which showed that the 'Yoga for Healthy Lower Backs' programme would be cost-effective both within the UK NHS and from a UK economic/societal point of view (August 15th 2012).

WORKPLACE HEALTH & WELLBEING. Employers are interested in this 12-week once-off 'best practice' course, because it was shown in the Spine journal published paper that those in the yoga group only had on average 3.83 days off work compared to 12.29 in the control (no yoga) group over the 12 months studied.  This was 70% reduction in work absenteeism over a year was shown to equate to savings of £817 per person to employers. Public Health England list the specific 'Yoga for Healthy Lower Backs' programme as one of seven musculoskeletal interventions that would offer a good return on investment (PHE MSK ROI tool and report 2017).

PUBLISHED RESEARCH Alison Trewhela has authored 6 research papers associated with this University of York/Arthritis Research UK randomized control trial ('Annals of Internal Medicine', 'Spine', 'Complementary Therapies in Clinical Practice', 'Physiotherapy', International Journal for Yoga Therapy).  She contributed to a published Delphi paper (Otago, New Zealand) which aimed to idenitify best methodological protocols for future yoga research and has also written a chapter for a book written by academics at Cardiff University.  Numerous articles have been written for magazines, newspapers and journals.  Case studies are being collated.


Yoga for Chronic Low Back Pain Clinical Research Trial – York Trials Unit at The Department of Health Sciences, The University of York, Generously funded by Arthritis Research UK.

details on

Alison originally began to teach 7-week Better Back Courses to small groups of 4-6 people in 1992 and those newcomers to yoga have been taught lifelong tools for improving, maintaining and managing the health of their lower backs, along with other beneficial mental and physiological side-effects. She was trained to take thorough case histories and to carry out individual yoga back assessments prior to commencement of attendance on these courses.

Because of this background and after several decades' experience of yoga teaching and yoga therapy, Alison was invited and approved to represent Iyengar Yoga Association UK on the largest and most significant piece of yoga research to date.  She has been heavily involved with this project since the initial planning stages in 2005 to the present time.  The high profile research trial was generously funded by Arthritis Research UK and was conducted by The York Trials Unit at The University of York.

‘A pragmatic multi-centred randomised controlled trial into the effectiveness of yoga as a treatment for chronic low back pain’.

Alison sat on the Trial Steering Committee for this trial and also attended the Independent Steering Committee meetings (mostly by teleconference and emails). The University of York employed Alison to:- devise the appropriate for beginners gentle yoga programme ‘Yoga for Healthy Lower Backs’; write the comprehensive Students’ Manual (now a book published by Lotus publishing called 'Yoga for Healthy Lower Backs' by Alison Trewhela and Anna Semlyen) and the 'Yoga for Healthy Lower Backs - Relaxations' 4-track audio CD, and the Teachers’ Manual; train, support and mentor the 20 yoga teachers that were selected to teach nationwide for the trial.

The trial was an exciting and efficient collaboration between Iyengar Yoga Association UK and The British Wheel of Yoga, plus York Trials Unit at The Department of Health Sciences at The University of York and Arthritis Research UK.  The yoga used in the 'Yoga for Healthy Lower Backs' research yoga programme reflects common ground for most schools and methods of yoga and teachers, and committee members of the two associations (and many schools of yoga) were consulted at multiple points along the trial's progress.  The yoga research builds on that carried out by Karen Sherman et al (where yoga was shown to be a good treatment option and also better than exercise classes taught by physiotherapists) and by K. Williams et al.

The 5 centres used for the trial yoga classes were Cornwall (Alison taught first and second wave yoga classes here), York, Manchester, North London and Central London. 50% of the 313 participants within the trial received 12 weekly 75-minute yoga classes which aimed to teach them how to practise yoga at home safely and effectively for the long-term health of their lower backs.  The other 50% were in the control group carrying on with ‘normal GP treatment’ for comparison.  Results were collated and data was analysed in 2010.  The yoga efficacy findings were published on November 1st 2011 in the pretstigious Annals of Internal Medicine where it was stated that physicians

 'could consider recommending yoga to those with a history of low back pain'.


The participants were followed up for 12 months and it was found that the benefits of the 12-week course were still maintained a year after beginning the yoga programme.  60% of those offered yoga were still practising at home the recommended 30 minutes twice a week.  The yoga group were shown how to integrate yoga into their daily lives.

The cost-effectiveness findings were published in Spine Journal on August 16th 2012.

The 'Yoga for Healthy Lower Backs' 12-week programme was found to be cost-effective for the ecomony and from the societal perspective.  Also that it would be likely to be cost-effective if this evidence-based effective treatment option were to be offered within an NHS setting (comparing it to physiotherapy packages and hospital clinics).  Those who had been offered the 12-week 'Yoga for Healthy Lower Backs' course had only an average of 3.83 days off work compared to 12.29 in the non-yoga control group over the 12 months studied.  It was shown that this reduction in approx. 70% work absenteeism could amount to over £800 per person per annum when considering lost productivity (based on average UK salary).

A Physiotherapy Journal published paper showed that those who attended six or more Yoga for Healthy Lower Backs classes benefitted even more than those who attended only a few (although even attending one or two classes gave benefit).  This shows this specialised yoga programme to be one of the best similarly-rigorously researched mainstream and complementary treatment options available (Also shown on a Forest Plot graph in the Annals of Internal Medicine paper).


Because part of the research trial's remit was to 'translate' the research findings, Alison Trewhela and Anna Semlyen, set up a social enterprise called with the aim of sharing this high-profile yoga research for the benefit of those with back pain (whilst also benefitting yoga generally, yoga teachers, occupational health / corporate human resources departments, Councils, NHS, communities, and back pain referrers).   



Alison is still in contact with the York Trials Unit as the yoga trial team have hopes of bidding successfully for grant funding for further yoga research into low back pain and other conditions, e.g. depression, yoga relaxation, improving quality of life of those living with osteoarthritis.

Alison also works with other yoga researchers and continues to work passionately to raise the profile of yoga and research.


'YOGA For Healthy Lower Backs' 12-Week Courses - Please go to this website's Yoga for Back Care Page.











Teacher Training for Yoga Teachers in

Yoga for Healthy Lower Backs programme (YHLB TT)   

Qualified and Experienced YOGA TEACHERS wishing to know more about training should contact Alison for further up-to-date details of possibilities and/or view 'Courses for Qualified Teachers' Page.  Various locations: Cornwall, Norfolk, Swansea, Sheffield, Dublin, Buckinghamshire, London, Liverpool, Wiltshire, Edinburgh, Stirlingshire, Leeds, Southampton, Newcastle, Warwickshire, Surrey and more.


'Yoga for Healthy Lower Backs'.

In order to have the beneficial impact deserved of the large, high-profile,
University of York 2005-2011 yoga research project, experienced (minimum of 4
years) well-qualified yoga teachers interested in training in how to deliver the 'Yoga for Healthy Lower Backs' programme are sought.

This research was published in one of the top international medical journals
(Nov 1st 2011) and showed the gentle Beginners' 12-week yoga course to be safe
and effective giving both short- and long-term improvements for those with
non-specific chronic low back pain. Comparing it to other equally
rigorously-tested treatment options for this prevalent condition (80% of
people), the RCT research showed that this yoga programme was one of the most
effective currently available and one that physicians should be comfortable to
recommend as a first-line treatment option. 

Furthermore, in another cost-evaluation published research paper (Aug 15th
2012), it showed that this yoga programme would be cost-effective for the NHS
and the economy/society compared to other options. This did not take into
account the probable life-long additional health promotional benefits that a
self-management yoga programme such as this is likely to offer. Over the 12
months studied, those in the yoga group had an average of only 3.83 days off
work compared to 12.29 in the usual care control group. The majority of the
yoga group participants were still practising yoga twice a week even 9 months
after completing the 12-week yoga intervention. 

The value of the research for yoga will be heightened and maintained if we
preserve the evidence-based programme in the way that the funding charity
Arthritis Research UK envisaged. The fully-resourced 12-week yoga programme
taught now in the same way as in the research is what is being looked for by
the general public, health professionals and commissioners. Remaining true to
the research will help to raise the profile of yoga and yoga teachers. The
eventual aim is to have teams of yoga teachers working within the NHS under
contracts via a central administration, meaning quality and standards will be

There are currently approx. --- (now over 350) trained in YHLB, but we need more of us. Please help by sharing with us in this continuing exciting project. If you
wish to train, or know someone you think should train, then teachers should
apply for full details by visiting the social enterprise website

Already trained YHLB Teachers are listed on the Yoga for Healthy Lower Backs Register.


site by Nick Long of Somerset Yoga